Individual provider Active NPI

Michael Anthony Amadeo, N.P.

  • Family Nurse Practitioner
  • San Diego, CA
National Provider Identifier
1376947648
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95001539 Issued in CA
Practice address
4077 5TH Ave
EMS
San Diego, CA 92103-2105
Phone
(626) 447-0296
Fax
(626) 623-1227
NPI assigned
Oct 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95001539 CA Primary

Addresses

Primary practice location

4077 5TH Ave
EMS
San Diego, CA 92103-2105

Mailing address

PO Box 1524
Arcadia, CA 91077-1524
Phone (626) 447-0296

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq Health Information Exchange (HIE) Southern California Permanente Medical Group

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150105001883 CA Practitioner - Nurse Practitioner 6305169004 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians
Scripps HealthGroup PAC ID 9234033853, 1,450 clinicians

Practice addresses (Care Compare)

10800 Magnolia Ave
Riverside, CA 92505-3043
Phone (951) 353-2000

9898 Genesee Ave
La Jolla, CA 92037-1205
Phone (858) 455-9100

Hospital & facility affiliations

  • Scripps Memorial Hospital la Jolla Hospital, La Jolla, CA, CCN 050324
  • Scripps Memorial Hospital - Encinitas Hospital, Encinitas, CA, CCN 050503

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern California Permanente Medical Group CurrentSince Aug 16, 2023 Accepting new patients
Southern California Permanente Medical Group CurrentSince Aug 16, 2023 Accepting new patients
Scripps Health Current Accepting new patients
Scripps Health Current Accepting new patients
Southern California Permanente Medical Group Current Accepting new patients
Scripps Health CurrentSince Jul 1, 2020 Accepting new patients
Scripps Health CurrentSince Jul 1, 2020 Accepting new patients
Pacific Emergency Providers, a Prof. Corp. CurrentSince Dec 1, 2014 Accepting new patients
Scripps Health Past Accepting new patients
Scripps Health Past Accepting new patients
Scripps Clinic Medical Laboratories Past Accepting new patients
Scripps Clinic Medical Group Past Accepting new patients
Scripps Health Past Accepting new patients

Locations

9898 Genesee Ave
La Jolla, CA 92037
Phone (858) 824-5222

9888 Genesee Ave
La Jolla, CA 92037
Phone (858) 457-4123

9898 Genesee Ave
#1
La Jolla, CA 92037

9898 Genesee Ave
Fl 1
La Jolla, CA 92037
Phone (515) 707-7960

File 54433
Los Angeles, CA 90074
Phone (858) 784-5645

393 E Walnut St
Fl 3
Pasadena, CA 91188
Phone (626) 405-7914

10800 Magnolia Ave
Riverside, CA 92505
Phone (951) 353-2000

4077 5th Ave
San Diego, CA 92103
Phone (619) 260-7245

4077 5th Ave
#M
San Diego, CA 92103
Phone (619) 260-7000

Interoperability endpoints

  • Direct secure messaging: mamadeo71788@scrippshlth.medalliesdirect.net

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1376947648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1524",
            "city": "ARCADIA",
            "state": "CA",
            "postal_code": "910771524",
            "telephone_number": "626-447-0296",
            "fax_number": "626-447-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4077 5TH AVE",
            "address_2": "EMS",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921032105",
            "telephone_number": "626-447-0296",
            "fax_number": "626-623-1227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMADEO",
        "first_name": "MICHAEL",
        "middle_name": "ANTHONY",
        "credential": "N.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-15",
        "last_updated": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95001539",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "10800 Magnolia Ave",
            "city": "Riverside",
            "state": "CA",
            "country_code": "US",
            "postal_code": "925053043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.